Medical Reimbursement Technician

To apply for this position, you must have the following qualifications: SPECIALIZED EXPERIENCE: Requires one (1) full year of specialized experience equivalent to at least the next lower grade level (GS-4) in the Federal Service that has given them the particular knowledge, skills and abilities required to successfully perform the duties of a Medical Reimbursement Technician.

Specialized experience includes: Communicating with staff to effectively discuss healthcare billing and insurance discrepancies; interpreting/applying insurance policies and requirements for billing; submitting health insurance claims for payment; and using a wide range of office software applications. (Resume(s) must clearly support the duties and experience required for this position. We will not make assumptions regarding experience.

OR SUBSTITUTION OF EDUCATION FOR EXPERIENCE (TRANSCRIPT REQUIRED): Successfully completed 4 years of education above high school level in any field for which high school graduation or equivalent is the normal prerequisite. OR COMBINATION OF EXPERIENCE AND EDUCATION (TRANSCRIPT REQUIRED): I have equivalent combination of education above high school (in excess of 2 years) and spec exp described above, meets total experience requirements for this position.

For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION Duties include but may not be limited to: Verifies insurance coverage for inpatient and outpatient services, enters updated information and maintains automated databases. Documents pre-admission requirements. Responsible for all reimbursable billing activities to include billing consideration of professional and facility services.

Validates Claims for billing purposes ensuring eligibility. Responsible for third party collections from insurance companies and for accounts receivable. Verifies accuracy of payments, resolves problems and discrepancies and closes out accounts. Responds to questions and inquiries from veterans and insurance companies. Explains eligibility and entitlements to veterans. Audits accounts, insuring payments recovered by insurance carrier are posted in a timely manner.

Possesses knowledge of medical coding (ICD-9, CPT/4, etc.) to validate coding for billing. Performs other duties as assigned. Work Schedule: Monday-Friday, 8:00am - 4:30pm Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not Approved Telework: This position may be authorized for Ad Hoc telework. Ad Hoc Telework eligibility will be discussed during the interview process. This position involves a multi-grade career ladder.

The major duties listed below represent the full performance level of GS 6. At the GS 5 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS 6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher-level work and availability of funds.